This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Postoperative nausea and vomiting (PONV) persists as one of the more common complications of surgery. Although rarely life-threatening, it is the postoperative outcome that ismost unfavorable to pateints, even more undesirable than pain. In orthognathic surgery, PONV is particularly challenging to the patient and has potentially detrimental consequences. Fractured facial bones are in unstable positions with relatively light weight fixation plates, blood clots are fragile and surgical wound sites are not entirely hemostatic. Any sudden head movement from vomiting can disturb this tenuous state. Also, vomiting can put the patient at risk for electorlyte imbalances and espiration, especially when the protective gag reflex is compromised by narcotics. The specific aim of this study is to see if patients taking aprepitant (orally) prior to surgery will have a significantly lower incidence of vomiting and complaints of nausea in comparison to the patients given ondansetron, thus allowing for faster recovery and less complications.